The Pennsylvania Supplemental Information Addendum to Group Workers Compensation Fund is a form that employers must complete and submit to the Group Workers Compensation Fund in order to be eligible for special group rates. This form collects information on the employer's workers' compensation policy, including the type of coverage, the number of employees, and other details. The information provided on the addendum is used to determine the employer's eligibility for the fund. There are two types of Pennsylvania Supplemental Information Addendum to Group Workers Compensation Fund: one for employers with more than 10 employees and one for employers with fewer than 10 employees.
Pennsylvania Supplemental Information Addendum to Group Workers Compensation Fund
State:
Pennsylvania
Control #:
PA-SKU-4667
Format:
PDF
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Description
Supplemental Information Addendum to Group Workers Compensation Fund
The Pennsylvania Supplemental Information Addendum to Group Workers Compensation Fund is a form that employers must complete and submit to the Group Workers Compensation Fund in order to be eligible for special group rates. This form collects information on the employer's workers' compensation policy, including the type of coverage, the number of employees, and other details. The information provided on the addendum is used to determine the employer's eligibility for the fund. There are two types of Pennsylvania Supplemental Information Addendum to Group Workers Compensation Fund: one for employers with more than 10 employees and one for employers with fewer than 10 employees.
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